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N.C. Weekly Influenza Summary - April 13, 2019 1
NORTH CAROLINA WEEKLY INFLUENZA SURVEILLANCE SUMMARY2018-2019 INFLUENZA SEASONWEEK ENDING APRIL 13, 2019
ILINet has now expanded to include emergency department data that were previously reported separately.
*For more information about national data visit https://www.cdc.gov/flu/weekly/index.htm.
(Influenza-Like Illness in ILINET)
Influenza Surveillance, NC 2016-2019
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
11%
% I
LI
10/06
10/20
11/03
11/17
12/01
12/15
12/29
01/12
01/26
02/09
02/23
03/09
03/23
04/06
04/20
05/04
05/18
Week Ending Date
2018-20192017-20182016-2017
StatewideUpdates
Influenza-like illness (ILI) slightly decreased for week ending April 13, 2019.
The geographic spread of flu was LOCAL for week ending 4/13/2019.
Of the four samples submitted to the State Laboratory of Public Health (SLPH) for viral testing this week(ending 4/13/2019) none were positive for influenza virus.
Hospital-based Public Health Epidemiologists (PHEs) reported 152 positive influenza virus results out of1517 samples tested during week 15 (ending 4/13/2019); 96 were positive for influenza A(unknown), 28were positive for influenza A(H3), 16 were positive for influenza A(H1), and 12 were positive for influenza Bvirus.
RegionalUpdates
The proportion of visits due to ILI in Region 4 (Southeastern US) was at 2.23% for week 14 (ending4/6/2019). The baseline for the region is 2.2%.
NationalUpdates
The proportion of outpatient visits due to ILI nationally was at 2.76% for week 14 (ending 4/6/2019). Thenational baseline for ILI is 2.2%.
InternationalUpdates
Worldwide seasonal influenza subtype A viruses accounted for a majority of detections. For more countryspecific details please visit:http://www.who.int/influenza/surveillance_monitoring/updates/latest_update_GIP_surveillance/en/
For more flu information visit https://flu.nc.gov and https://www.cdc.gov/flu.
N.C. Weekly Influenza Summary - April 13, 2019 2
INFLUENZA-LIKE ILLNESSES
By Reporting Sites, 2018-2019
Week # - Ending (Sentinels Reporting) # ILI # Patients % ILI
#40 - 10/06/2018 157 974 108,547 0.90
#41 - 10/13/2018 160 1139 108,746 1.05
#42 - 10/20/2018 161 1261 109,669 1.15
#43 - 10/27/2018 161 1425 104,003 1.37
#44 - 11/03/2018 162 1548 106,418 1.45
#45 - 11/10/2018 161 1428 94,176 1.52
#46 - 11/17/2018 162 1389 82,670 1.68
#47 - 11/24/2018 159 1263 75,983 1.66
#48 - 12/01/2018 159 1843 102,756 1.79
#49 - 12/08/2018 158 1793 101,347 1.77
#50 - 12/15/2018 155 1779 90,867 1.96
#51 - 12/22/2018 152 1928 96,749 1.99
#52 - 12/29/2018 155 2573 92,349 2.79
#1 - 01/05/2019 157 2776 102,884 2.70
#2 - 01/12/2019 154 2366 102,084 2.32
#3 - 01/19/2019 158 2620 102,440 2.56
#4 - 01/26/2019 157 3601 102,915 3.50
#5 - 02/02/2019 155 4914 107,517 4.57
#6 - 02/09/2019 156 7608 121,081 6.28
#7 - 02/16/2019 158 7143 113,442 6.30
#8 - 02/23/2019 156 6405 109,587 5.84
#9 - 03/02/2019 156 4963 106,467 4.66
#10 - 03/09/2019 156 3876 101,799 3.81
#11 - 03/16/2019 154 3694 108,147 3.42
#12 - 03/23/2019 156 2994 109,642 2.73
#13 - 03/30/2019 153 2675 110,024 2.43
#14 - 04/06/2019 151 2118 106,396 1.99
#15 - 04/13/2019 147 1784 108,577 1.64
N.C. Weekly Influenza Summary - April 13, 2019 3
PHE RESPIRATORY VIRAL PATHOGEN SURVEILLANCE
Positive test results for selected respiratory viruses are reported on a weekly basis by Public Health Epidemiologists(PHEs) located in seven of the largest hospital networks across North Carolina. The graph below shows the number ofpositive tests for respiratory syncytial virus (RSV), parainfluenza, adenovirus, rhinovirus, and human metapneumovirus(hMPV) by week.
These data provide a useful indication of which other respiratory viruses are circulating and possibly contributing to ILI inthe state. Please note that the total number of tests performed is not available from all hospital networks, so the overallproportion testing positive cannot be calculated. Also, testing protocols and practices differ among hospitals. Finally,these numbers reflect test results from participating hospitals only and might not be reflective of the entire state.
*Most facilities use tests that do not distinguish rhinoviruses from enteroviruses.
(Data source: NC DETECT)
PHE Surveillance: Positive Respiratory Virus Test Results by Week
0
80
160
240
320
400
480
560
640
720
800
880
960
1040
1120
1200
1280
1360
Co
un
t
10/06
10/20
11/03
11/17
12/01
12/15
12/29
01/12
01/26
02/09
02/23
03/09
03/23
04/06
04/20
05/04
05/18
Week Ending Date
InfluenzahMPVRhinovirus*AdenovirusParainfluenzaRSV
Da
ta in
sha
de
d a
rea
ma
y be
inc
om
ple
te
• Influenza was the most frequently identified respiratory viral pathogen during week 15 (ending 04/13/2019) followed by Rhinovirus*.
Influenza Virus Isolates Identified by PHE Facilities for 2018–2019 Season*Influenza Virus Isolates Identified by PHE Facilities for 2018–2019 Season*
Virus Type# New positive results
(04/07/2019- 04/13/2019)# Cumulative positive results
(09/30/2018-05/18/2019)
A(H1) 16 785
A/H3 28 1037
A (subtype unknown) 96 7077
B 12 155
Total 152 9054
*2018-2019 influenza season began September 30, 2018.NOTE: This table includes isolates tested as of 09/30/2018.
N.C. Weekly Influenza Summary - April 13, 2019 4
PHE ACUTE RESPIRATORY ADMISSIONS SURVEILLANCE
The number of patients admitted to the hospital with fever plus respiratory symptoms in the absence of a known causeother than influenza is reported on a weekly basis by Public Health Epidemiologists (PHEs) located in seven of the largesthospital networks across North Carolina. The graph below shows the number of acute respiratory illness admissions toparticipating hospitals by age group.
In conjunction with other surveillance information, these data help us monitor for changes in severity of respiratoryillness during periods when influenza is circulating. Please note that these reports are not limited to patients withlaboratory-confirmed influenza infection. Also, these numbers reflect admissions to participating hospitals only and arenot be reflective of the entire state.
Data source: NC DETECT
PHE Surveillance: Hospital Admissions for Acute Respiratory Illness by Week
0
20
40
60
80
100
120
140
160
180
200
220
240
260
280
300
320
340
360
Co
un
t
10/06
10/20
11/03
11/17
12/01
12/15
12/29
01/12
01/26
02/09
02/23
03/09
03/23
04/06
04/20
05/04
05/18
Week Ending Date
TotalAge UnknownAge 65+Age 25 - 64Age 5 - 24Age 0 - 4
Da
ta in
sha
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y be
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• Acute respiratory admissions decreased during week 15 (ending 04/13/2019).
• The highest number of acute respiratory admissions during week 15 was for patients Age 25 - 64 followed by Age 65+.
N.C. Weekly Influenza Summary - April 13, 2019 5
Influenza Positive Tests Reported by the NC State Laboratory of Public Health (SLPH)
† Percent of submitted specimens for any influenza.
0
5
10
15
20#
Po
siti
ve S
pe
cim
en
s
10/06
10/20
11/03
11/17
12/01
12/15
12/29
01/12
01/26
02/09
02/23
03/09
03/23
04/06
04/20
05/04
05/18
Week Ending Date
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% P
osi
tive
†
B (not subtyped)B (Yamagata)B (Victoria)Seasonal A (H3)2009 A (H1N1)A (not subtyped)
Percent Positive †
Influenza Virus Isolates From In-State Patients Identified by the State Laboratory Of Public Health 2018–2019 Season*Influenza Virus Isolates From In-State Patients Identified by the State Laboratory Of Public Health 2018–2019 Season*
Virus Type # New Positive Results # Cumulative Positive Results
A (unknown) 0 10
2009 A(H1N1) 0 87
A(H3) 0 76
B (unknown) 0 0
B (Victoria) 0 1
B (Yamagata) 0 1
Total 0 175
*2018-2019 influenza season began September 30, 2018.NOTE: This table includes isolates tested as of 09/30/2018. This table does not include influenza isolates
identified by other laboratories.
Influenza Positive Tests Reported by the NC State Laboratory of Public Health (SLPH) and PHE Facilities
† Percent of submitted specimens for any influenza.
0
500
1000
1500
# P
osi
tive
Sp
eci
me
ns
10/06
10/20
11/03
11/17
12/01
12/15
12/29
01/12
01/26
02/09
02/23
03/09
03/23
04/06
04/20
05/04
05/18
Week Ending Date
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% P
osi
tive
†
Seasonal BSeasonal A (H3)A (H1)A (not subtyped)
Percent Positive †
N.C. Weekly Influenza Summary - April 13, 2019 6
FLU SURVEILLANCE BY REGIONS
*This graph begins with data starting week ending October 6, 2018 for the 2018-2019 influenza season.
NC DETECT ED Influenza-Like Illness (ILI), 2018-2019
Percentage of Total Visits by Week
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
% I
LI
10/06
10/20
11/03
11/17
12/01
12/15
12/29
01/12
01/26
02/09
02/23
03/09
03/23
04/06
04/20
05/04
05/18
Week Ending Date
Region 7Region 6Region 5Region 4Region 3Region 2Region 1
Flu Surveillance Regions
Region 1 Region 2 Region 3 Region 4Region 5 Region 6 Region 7
ALAMANCE
ALEXANDER
ALLEGHANY
ANSON
ASHE
AVERY
BEAUFORT
BERTIE
BLADEN
BRUNSWICK
BUNCOMBE
BURKE
CABARRUS
CALDWELL
CAMDEN
CARTERET
CASWELL
CATAWBA CHATHAM
CHEROKEE
CHOWAN
CLAY
CLEVELAND
COLUMBUS
CRAVEN
CUMBERLAND
CURRITUCK
DAREDAVIDSON
DAVIE
DUPLIN
DURHAM
EDGECOMBE
FORSYTH
FRANKLIN
GASTON
GATES
GRAHAM
GRANVILLE
GREENE
GUILFORD
HALIFAX
HARNETT
HAYWOOD
HENDERSON
HERTFORD
HOKE
HYDE
IREDELL
JACKSON
JOHNSTON
JONES
LEE
LENOIR
LINCOLN
MC DOWELL
MACON
MADISON MARTIN
MECKLENBURG
MITCHELL
MONTGOMERYMOORE
NASH
NEW HANOVER
NORTHAMPTON
ONSLOW
ORANGE
PAMLICO
PASQUOTANK
PENDER
PERQUIMANS
PERSON
PITT
POLK
RANDOLPH
RICHMOND
ROBESON
ROCKINGHAM
ROWAN
RUTHERFORD
SAMPSON
SCOTLAND
STANLY
STOKESSURRY
SWAIN
TRANSYLVANIA
TYRRELL
UNION
VANCE
WAKE
WARREN
WASHINGTON
WATAUGA
WAYNE
WILKES
WILSON
YADKIN
YANCEY
3
45
6
1
7
2
N.C. Weekly Influenza Summary - April 13, 2019 7
NC INFLUENZA-ASSOCIATED DEATHS
An influenza-associated death is defined for surveillance purposes as a death (adult or pediatric) resulting from aclinically compatible illness that was confirmed to be influenza by an appropriate laboratory or rapid diagnostic test withno period of complete recovery between the illness and death.
NC Influenza-Associated Deaths*
Influenza-Associated DeathsThis Week (04/07/2019 – 04/13/2019)
Total Influenza-Associated DeathsThis Season (starting 09/30/2018)
4 192
*These numbers are based on reports submitted by providers to the NC Division of Public Health. Data arepreliminary and subject to change as updated information becomes available. Deaths that occurred on or after
09/30/2018 will be reflected in this report for the 2018-2019 season.
Reported in North Carolina by Age Group*
Laboratory Confirmed Influenza-Associated Deaths
08
1624324048566472808896
104112120
No
. of
Re
po
rte
d D
ea
ths
0-4 5-17 18-24 25-49 50-64 65+
Age Group (Years)
Reported in North Carolina by Week of Death*
Laboratory Confirmed Influenza-Associated Deaths
0 0 01 1
2
0 01 1
3
1
3
8
23
5
9
18
27
32
17
19
10 109
6
4
0
3
6
9
12
15
18
21
24
27
30
No
. o
f R
ep
ort
ed
De
ath
s
10/06
10/13
10/20
10/27
11/03
11/10
11/17
11/24
12/01
12/08
12/15
12/22
12/29
01/05
01/12
01/19
01/26
02/02
02/09
02/16
02/23
03/02
03/09
03/16
03/23
03/30
04/06
04/13
04/20
04/27
05/04
05/11
05/18
Week Ending Date
PediatricAdult
N.C. Weekly Influenza Summary - April 13, 2019 8
ILI Network Provider Locations, NC 2018-2019
Non-Hospital Participants In North Carolina’s Influenza Sentinel Surveillance Program Report Data To CDC
LOCAL HEALTH DEPARTMENT/DISTRICT OFFICES - 21
Alamance County Health Department
Cabarrus Health Alliance
Caldwell County Health Department
Craven County Health Department
Duplin County Health Department
Franklin County Health Department
Henderson County Health Department
Johnston County Health Department
Lee Primary Care
Montgomery County Health Department
Northampton County Health Department
Pender County Health Department
Pitt County Public Health Center
Richmond County Health Department
Rockingham County Health Department
Stanly County Health Department
Stokes Family Health Center
Surry County Health and Nutrition Center
Union County Health Department
Wake County Health Department, Children’s Clinic
Wilkes County Health Department
PRIVATE PRACTITIONERS - 24
Bakersville Community Medical Center
Blue Cross and Blue Shield of N.C.
Blue Ridge Community Health Services
Butner-Creedmoor Family Medicine
Catawba Family Care
Coastal Childrens Clinic
Colerain Primary Care
Creswell Primary Care
Dilworth Pediatrics
ECU Brody School of Medicine – Department ofPediatrics
Family Care Center
Haywood Pediatric and Adolescent Medicine Group, PA
Hot Springs Health Program
MEDAC Health Services at Shipyard Blvd.
MEDAC Health Services at Porter’s Neck
MEDAC Health Services at Military Cutoff
Minute Clinic - Cary
Murfreesboro Primary Care
Oxford Family Physicians
PrimeCare
PrimeCare of Northpoint
Roanoke Chowan Community Health Center
SAS Institute Health Care Center
Sisters of Mercy Urgent Care, South
COLLEGES AND UNIVERSITIES STUDENT HEALTHPROGRAMS - 15
Appalachian State University Student Health Services
Davidson College Student Health Center
ECU Student Health Services
Elizabeth City State University Student Health Services
Elon University R. N. Ellington Health and CounselingCenter
Fayetteville State University
Meredith College Student Health Center
NC Agricultural &Technical State University StudentHealth Services
NC State University Student Health Services
UNC-Chapel Hill Student Health Services
UNC-Charlotte Student Health Services
UNC-Greensboro Student Health Services
UNC-Pembroke Student Health Services
Wake Forest University Student Health Services
Winston-Salem State University